Kilimanjaro Altitude Sickness

Acclimatization and Altitude Sickness on Kilimanjaro

Mount Kilimanjaro, the tallest summit on the African continent, stands at 5,895 meters (19,341 ft). Kilimanjaro offers a unique set of problems, the most hazardous of which is altitude sickness. A considerable proportion of those who climb more than 9,000 feet get altitude-related illnesses. At Climbing Kilimanjaro, safety is our priority.

Effects of Altitude on Kilimanjaro

Kilimanjaro has become a popular journey because it allows average hikers to experience a high mountain summit without requiring technical skills. Because it is a “walk-up” with no need for ropes or climbing gear, some people overlook the possibility for serious, life-threatening conditions caused by the altitude.

Kilimanjaro’s peak, along with Aconcagua and Denali (Mt McKinley), is classified as “extreme altitude”. Everest and K2 are “ultra” altitudes, thus acclimation is difficult.

A Brief Introduction to Altitude

At the peak of Kilimanjaro, there is around 49% less oxygen than at sea level. However, the amount of oxygen in the air does not change; rather, the barometric pressure (air pressure) of the atmosphere is lowered.

The proportion of oxygen in the air remains constant at 20.9%, but its availability is reduced due to lower air pressure. Simply said, for every volume of air you take in, there are less molecules of oxygen accessible.

Reduced air pressure also causes fluid to pool outside of cells, around the brain (High Altitude Cerebral Edema) and the lungs (High Altitude Pulmonary Edema), both of which are dangerous disorders.

Altitude Sickness: What is it?

Mountain sickness is classified into three types: acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema. Furthermore, AMS can be mild, moderate, or severe.

Let us take a deeper look at these situations.

Acute Mountain Sickness

According to Dr. Peter Hackett of the Institute for Altitude Medicine, AMS can affect anyone above 6,000ft. The initial sign is usually a headache, which confusingly can also be a sign of dehydration or over-exertion. If other symptoms develop, then a diagnosis of AMS is probable.

Mild AMS

In it’s mildest form, the symptoms can resemble that of a hangover, with nausea, headache, fatigue, and a loss of appetite. If you experience any of these symptoms it’s important to tell your guide and not simply try to push through. Mild symptoms can often be resolved with rest and adequate hydration.

Moderate AMS

If the symptoms of mild AMS start to get worse, a headache that you can’t shift, dizziness, coughing, shortness of breath, nausea and vomiting this is an indication that you are not adapting to the altitude (acclimatizing) and at this point you should descend to the last elevation that you felt “well”.

Treatments such as ibuprofen for the headache or anti-emetics for the nausea can mask worsening symptoms and should not be relied upon for continued ascent.

Severe AMS

If a person suffering with mild AMS ignores the symptoms and continues to a greater elevation, the illness may worsen. Severe AMS can cause life-threatening complications (HAPE and HACE), hence urgent descent is required.

Symptoms may include a strong headache, ataxia (loss of coordination, difficulty to move properly, stumbling), increased coughing, and shortness of breath. Someone with severe AMS will most certainly require evacuation from the mountain via stretcher or helicopter.

The complications of severe mountain sickness include HAPE and HACE.

High Altitude Pulmonary Edema (HAPE)

According to Basecamp MD, HAPE can develop when the pulmonary arteries experience high pressure due to a low-oxygen environment. This pressure creates an accumulation of fluid around the lungs.

Surprisingly, a climber can acquire HAPE even if they do not exhibit signs of acute AMS.

Look out for:

• Coughing up blood or mucus
• Abnormal lung sounds
• Extreme listlessness
• Difficulty breathing
• Lips going blue
• Confusion, lack of coordination

Anyone at altitude who believes they have a respiratory illness should presume it is HAPE unless a medical practitioner confirms otherwise. If HAPE is suspected, oxygen is frequently supplied along with rapid transport to a medical institution.

As oxygen levels in the blood fall, the brain may suffer from a shortage of oxygen, resulting to HACE.

High Altitude Cerebral Edema

HACE is a severe illness that demands prompt medical attention. As fluid accumulates around the brain, the climber becomes progressively disoriented, sluggish, and sleepy, unable to move, and behaves abnormally.

Look out for:

• Disorientation, confusion, hallucinations, talking nonsense
• Lack of coordination, staggering, inability to walk
• Irrational behavior
• Severe headache, sometimes accompanied by nausea and vomiting

HACE cannot be treated without immediate evacuation to a medical facility.

How is Altitude Sickness Diagnosed?

Climbing Kilimanjaro guides will use a pulse oximeter to assess your oxygen saturation and pulse rate during our daily health checks, and this data, together with any symptoms you show, will help us develop a picture of your situation.

Lake Louise Scoring System

The Lake Louise Scoring System, developed in 1991 and revised in 2018, continues to serve as the foundation for the majority of climber condition diagnoses. Climbing Kilimanjaro guides use this approach to measure your fitness. The score’ assigns a number based on the severity of your ailment.

Acclimatization: Preventing Altitude Sickness

Acclimatization or “acclimation” refers to the body’s compensatory mechanisms for adjusting to the low-oxygen, low-atmospheric pressure environment. From the outset, your body will begin to create adaptive adjustments to compensate.

What you will notice:

Breathing deeper and sometimes quicker
Increased resting heart rate
Potentially elevated blood pressure.

As you gently climb, your body employs various systems to adapt:

Producing more oxygen-carrying hemoglobin
Higher erythropoietin production, which is a hormone from the kidneys that enhances the synthesis of red blood cells.
Lower plasma volume, which increases the risk of dehydration.
Increased kidney function when excess bicarbonate ions are expelled as a result of a shift in the blood's acid/alkali balance.

All of these changes occur gradually, which is why routes with an effective acclimatization procedure have the highest and safest summit success rates. The longer it takes to reach a high altitude, the longer your body has to adjust.

Building in acclimatization days “hike high, sleep low” and rest days boosts your chances of sufficient adaptation, resulting in a decreased risk of mountain sickness.

Acclimatization is a complex process, and some people appear to have no trouble at all. There are no secrets or hacks; it’s simply a question of time, however, the medicine Diamox has been found to boost the body’s natural acclimatization processes and can assist speed them up.

How to Avoid Altitude Sickness on Kilimanjaro

Take the longer path. Instead of taking the shortest path up Kilimanjaro, choose a route that allows you some acclimatisation time. Climbing Kilimanjaro requires much training and preparation.
Hike slowly. Your guides will remind you of the “pole pole” (slowly, slowly in Swahili). You don’t want to tire yourself out, therefore always attempt to be the last person to enter the camp.
Even if you’re fit, you should preserve your energy and prevent overexertion. Fatigue is thought to be a significant component of AMS.
Stay hydrated. Maintaining your fluid intake minimizes dehydration in the dry air, which can impair your ability to acclimate.

Ask your doctor if Diamox is appropriate for you.
If you have signs of altitude sickness, don’t climb any higher.
Avoid narcotic painkillers, sleeping medications, alcohol, and stimulants.
Always notify your guide if you get a headache, nausea, or any other symptoms.
Keep eating, especially carbs. According to US Army research, carbohydrates improve ventilation and are the most effective fuel for high-altitude exercise.
Stay warm. Hypothermia is harmful, therefore never stay in damp garments.

Does Altitude Training help Acclimatization?

Altitude Training is becoming more popular among aspiring mountaineers. Some athletes adopt these training routines to improve their performance, and research has revealed a “per-acclimatization” process as a consequence.

The methods range from training in a simulated altitude chamber to sleeping in a hypnotic tent and even periodic exposure to hypoxic air while resting. For additional details, please refer to our comprehensive altitude training guide.

The ideal pre-acclimatization strategy is to climb Mt Meru or other peaks in your native country before heading to Kilimanjaro. This is not possible for everyone, nor is it required, but if you have access to high altitude, you’ll get a decent notion of how well you acclimate.

Effects of Altitude on existing Conditions

Your doctor will let you know whether your medical history precludes you from traveling to altitude. Many people with well-managed pre-existing conditions can climb Kilimanjaro successfully.

Anyone with heart, lung, or neurological issues must obtain medical clearance from their doctor before participating in one of our climbs. It is also crucial for your doctor to consider how altitude may affect your existing drugs and condition. Be aware that some medical issues might make obtaining appropriate travel insurance more difficult.

Effects of Altitude on Sleep: Cheyne-Stokes Breathing

Periodic breathing is one of the most common causes of sleep disturbances at altitude. This is not always related to altitude sickness, although it may be painful and disruptive. According to the Institute for Altitude Medicine, there is a “battle in the body over control of breathing during sleep”. The oxygen sensors signal the parasympathetic nervous system to breathe deeper, but the carbon dioxide sensors tell it to stop.

The end result is generally deep breathing, followed by a pause, and then another deep breath when the breathing resumes. Diamox is frequently used to treat this disease.

Other Health Considerations on Kilimanjaro

While altitude sickness is the primary issue, you should be proactive about your health while ascending.

Hypothermia

Never stay in damp clothing. A minor cold, whether caused by rainfall or perspiration, can quickly evolve into hypothermia if you stop moving, especially further up the mountain. Make sure you have enough clothing in your day bag, since temperature fluctuations are normal as you rise.

The Sun’s Rays

Always use sunscreen, ideally factor 40+, and cover any exposed areas of your body, especially your head and neck. As you rise, there is less atmosphere to block dangerous UV radiation, and the sun’s rays are harsher.

Most essential, wear sunglasses that block 100% of UV radiation. Wraparound glasses are ideal for preventing reflected UV from glaciers and snow from hurting your eyes. Snow blindness is uncommon, but it is a serious risk if you do not protect your eyes.

Gastro-intestinal issues

Traveling to isolated areas increases the risk of gastro-intestinal problems. Stomach issues can be caused by a variety of meals, poor hygiene, or contact to germs and viruses. Always apply anti-bacterial gel or wipes on your hands, especially before eating.

Your primary risk of gastrointestinal problems occurs before to your ascent. Avoid street food, tap water, salads, and unpeeled fruit. On the mountain, we strictly adhere to food hygiene procedures and always supply safe, filtered water.

Climbing Kilimanjaro Safety Procedures

When climbing Kilimanjaro, we take your safety extremely seriously. Climbing Kilimanjaro experienced guides will continuously supervise you, but they will need your assistance. If you feel sick, notify your guide right away. Keep an eye on the other members of your group; if you notice someone acting abnormally or appearing to be in pain, notify your guide.

Every day, your guide will use a pulse oximeter to assess your oxygen saturation, ask you questions about how you feel, and listen to your chest for strange lung sounds. Catching it early is the greatest approach to keep moderate altitude sickness from worsening.

The climbing Kilimanjaro Team carries emergency oxygen, and the National Park provides portable stretchers on each climb. If a climber is in distress and unable to continue, we have teamed with Kilimanjaro Air Rescue for emergency evacuation.